Brace limiting range of motion and method of using same

ABSTRACT

A brace is provided including an upper support arm, a lower support arm, and a hinge assembly. The hinge assembly includes an upper hinge plate coupled to the upper support arm and including a first plurality of teeth disposed along at least a portion of a perimeter of the upper hinge plate. The hinge assembly includes a lower hinge plate coupled to the lower support arm and including a second plurality of teeth disposed along at least a portion of a perimeter of the upper hinge plate. The hinge assembly includes an axle rotatably coupling the upper and lower hinge plates. The hinge assembly includes a locking element disposed on the upper hinge plate and including first and second protrusions configured to physically contact opposite sides of one of the second plurality of teeth in a first orientation, thereby prohibiting relative rotation between the upper and lower support arms.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No.62/782,707, filed on Dec. 20, 2018, the entire contents of which arehereby incorporated by reference.

BACKGROUND Field of the Disclosure

The present disclosure relates generally to a brace configured to limita range of motion of a joint of a user and a method of using the same.

Description of the Related Technology

Damaged ligaments, cartilage, and tendons in joints are not an uncommonoccurrence, particularly with today's emphasis on physical activity andconditioning. Few injuries interfere with motion more than injuries tothe knee. Knee injuries account for approximately 60% of all sportsrelated injuries with nearly half of those injuries occurring to theACL. ACL injury is most prevalent (1 in 1,750 persons) in patientsbetween the ages of 15 and 45, due in no small measure to their moreactive lifestyle as well as higher participation in sports. A person whohas torn their ACL has a 15 times greater risk of a second ACL injuryduring the initial 2 months after ACL reconstruction, and risk of ACLinjury to the opposite knee is two times that of the restructured knee.

There are four main ligaments which hold the knee together: AnteriorCruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), MedialCollateral Ligament (MCL) and Lateral Collateral Ligament (LCL). Thereare over 200,000 ACL injuries that occur in the United States annually.Approximately 50% of ACL injuries occur with injuries to otherstructures of the knee. While less common than an ACL injury, injuriesto the PCL account for between 3% to 20% of all knee ligament injuries.The collateral ligaments, MCL and LCL, are responsible for 25% of kneeinjuries in competitive athletes.

Treatments for ACL and other ligament injuries include surgical andnon-surgical options. Braces are employed to limit range of motion,promote support and stabilization while ligaments heal. In the case ofACL surgery, graft strength of a new ACL is considerably weaker than thenative ACL during the first 12 months, so a brace configured to limitthe range of motion of a joint of the user during this early periodhelps protect it from harmful forces that occur in everyday life or insports activity.

SUMMARY

According to some embodiments, a brace configured to restrict a range ofmotion of a joint of a subject is provided. The brace includes an uppersupport arm. The brace includes a lower support arm. The brace includesa hinge assembly. The hinge assembly includes an upper hinge platecoupled to the upper support arm and comprising a first plurality ofteeth disposed along at least a portion of a perimeter of the upperhinge plate. The hinge assembly includes a lower hinge plate coupled tothe lower support arm and comprising a second plurality of teethdisposed along at least a portion of a perimeter of the upper hingeplate. The hinge assembly includes an axle rotatably coupling the upperhinge plate and the lower hinge plate. The hinge assembly includes alocking element disposed on the upper hinge plate. The locking elementincludes a first protrusion and a second protrusion configured tophysically contact opposite sides of one of the second plurality ofteeth in a first orientation, thereby prohibiting rotation of the uppersupport arm with respect to the lower support arm.

According to some embodiments, a method of restricting a range of motionof a joint of a subject utilizing a brace configured for attachment tothe joint is provided. The method includes securing an upper support armof the brace against an upper portion of an appendage of the subject.The method includes securing a lower support arm of the brace against alower portion of the appendage. The method includes restricting a rangeof motion of the upper support arm with respect to the lower support armutilizing a hinge assembly of the brace. The hinge assembly includes anupper hinge plate coupled to the upper support arm and comprising afirst plurality of teeth disposed along at least a portion of aperimeter of the upper hinge plate. The hinge assembly includes a lowerhinge plate coupled to the lower support arm and comprising a secondplurality of teeth disposed along at least a portion of a perimeter ofthe upper hinge plate. The hinge assembly includes an axle rotatablycoupling the upper hinge plate and the lower hinge plate. The hingeassembly includes a locking element disposed on the upper hinge plate,the locking element comprising a first protrusion and a secondprotrusion configured to physically contact opposite sides of one of thesecond plurality of teeth in a first orientation, thereby prohibitingrotation of the upper support arm with respect to the lower support arm.

According to some embodiments, a method of manufacturing a braceconfigured to restrict a range of motion of a joint of a subject isprovided. The method includes providing an upper support arm. The methodincludes providing a lower support arm. The method includes assembling ahinge assembly. Assembling the hinge assembly includes coupling an upperhinge plate to the upper support arm, the upper hinge plate comprising afirst plurality of teeth disposed along at least a portion of aperimeter of the upper hinge plate. Assembling the hinge assemblyincludes coupling a lower hinge plate to the lower support arm, thelower hinge plate comprising a second plurality of teeth disposed alongat least a portion of a perimeter of the upper hinge plate. Assemblingthe hinge assembly includes rotatably coupling the upper hinge plate andthe lower hinge plate via an axle. Assembling the hinge assemblyincludes disposing a locking element on the upper hinge plate. Thelocking element includes a first protrusion and a second protrusionconfigured to physically contact opposite sides of one of the secondplurality of teeth in a first orientation, thereby prohibiting rotationof the upper support arm with respect to the lower support arm.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a brace configured for attachment to a joint of auser, in accordance with some embodiments;

FIG. 2A illustrates a hinge assembly of the brace of FIG. 1, inaccordance with some embodiments;

FIG. 2B illustrates the hinge assembly FIG. 2A further comprising awindow configured to provide visual indication of a locked state of thehinge assembly, in accordance with some embodiments;

FIG. 3A illustrates a plan view of a hinge assembly of the brace of FIG.1 in an unlocked configuration, in accordance with some embodiments;

FIG. 3B illustrates a perspective view of the hinge assembly of FIG. 3Ain the unlocked configuration;

FIG. 4A illustrates a plan view of a hinge assembly of the brace of FIG.1 in a locked configuration, in accordance with some embodiments;

FIG. 4B illustrates a perspective view of the hinge assembly of FIG. 4Ain the locked configuration, in accordance with some embodiments;

FIG. 5A illustrates a plan view of another hinge assembly of the braceof FIG. 1 in an unlocked configuration, in accordance with someembodiments;

FIG. 5B illustrates a plan view of the hinge of FIG. 5A in a lockedconfiguration;

FIG. 6 illustrates a perspective view of a locking mechanism of thebrace of FIG. 1, in accordance with some embodiments;

FIG. 7 illustrates a cutaway view of a hinge assembly of the brace ofFIG. 1, according to some embodiments;

FIG. 8A illustrates a perspective view of a portion of the brace of FIG.1, according to some embodiments;

FIG. 8B illustrates a perspective view of a lower portion of the braceof FIG. 1 in a maximally extended position, according to someembodiments;

FIG. 8C illustrates a perspective view of attachment of a cuff to asupport arm according to some embodiments;

FIG. 8D illustrates the cuff of FIG. 8C separated from the support arm;

FIG. 8E illustrates a perspective view of a lower portion of the braceof FIG. 1 in a minimally extended position, according to someembodiments;

FIG. 8F illustrates a perspective view of an upper portion of the braceof FIG. 1 in a minimally extended position, according to someembodiments;

FIG. 9A illustrates an adjustable cuff for a lower support arm accordingto some embodiments;

FIG. 9B illustrates the cuff of FIG. 9A being attached to the lowersupport arm;

FIG. 9C illustrates a perspective view of a lower portion of the braceof FIG. 1 in a minimally extended position using the cuff of FIG. 9A,according to some embodiments;

FIG. 9D illustrates an adjustable cuff for an upper support armaccording to some embodiments;

FIG. 9E illustrates the cuff of FIG. 9D attached to the upper supportarm;

FIG. 9F illustrates a perspective view of an upper portion of the braceof FIG. 1 in a minimally extended position using the cuff of FIG. 9D,according to some embodiments;

FIG. 10 illustrates a perspective view of a buckle for use with thebrace of FIG. 1, according to some embodiments;

FIG. 11 illustrates a flowchart of a method a method of using a braceconfigured for attachment to a joint of a subject, in accordance withsome embodiments; and

FIG. 12 illustrates a flowchart of a method of a method of manufacturinga brace configured for attachment to a joint of a subject, in accordancewith some embodiments.

DETAILED DESCRIPTION

Embodiments of this disclosure relate to orthopedic braces for use intreating a variety of injuries to the knee, or other joint, andsurrounding ligaments. More particularly, embodiments of the bracedisclosed herein may be intended for use in post-operative activitiesand/or activities of daily living for patients with ACL deficiencies,collateral ligament deficiencies, hyperextension injury, or forprophylactic use.

Orthotic bracing and support can promote healing and wellness throughthe benefit of natural motion through safe ranges of motion (ROM) and/orby locking a joint in a desired orientation. Post-surgical recovery ofthe patient may be at least partially dependent upon locking theaffected joint in a desired orientation and/or limiting ROM to apredetermined safe range. Accordingly, there is a need for bracingsolutions configured to lock the affected joint in a desired orientationand/or limit ROM to a predetermined safe range.

A better understanding of the various features of the disclosure can begleaned from the following description read in conjunction with theaccompanying drawings in which like reference characters refer to likeelements, where reasonably applicable. While the disclosure may besusceptible to various modifications and alternative constructions,certain illustrative features are shown in the drawings and aredescribed in detail below. It will be understood, however, that there isno intention to limit the disclosure to the specific embodimentsdisclosed, but to the contrary, the intention is to cover allmodifications, alternative constructions, combinations, and equivalentsfalling within the spirit and scope of the disclosure.

Furthermore, it will be appreciated that unless a term is expresslydefined in this disclosure to possess a described meaning, there is nointent to limit the meaning of such term, either expressly orindirectly, beyond its plain or ordinary meaning.

For ease of understanding the disclosed features of an orthopedicdevice, as used herein, “proximal” has its ordinary meaning and refersto a location situated next to or near the point of attachment or originor a central point or located toward the center of the body. Likewise,the term “distal” has its ordinary meaning and refers to a location thatis situated away from the point of attachment or origin or central pointor located away from the center of the body. The term “medial” refers toa position that is closer to the midline of the body, whereas the term“lateral” refers to a position further from the midline of the body. Theterms “upper” and “lower” describe the position of certain elements asbeing either above or below a hinge assembly of the brace. An “upper”element is above the hinge assembly and knee or other joint, whereas a“lower” element is below the hinges assembly and knee or other joint.The term “posterior” also has its ordinary meaning and refers to alocation that is behind or to the rear of another location or feature.Lastly, the term “anterior” has its ordinary meaning and refers to alocation that is ahead of or to the front of another location orfeature.

The terms “rigid,” “flexible,” “malleable” and “resilient” may be usedherein to distinguish portions of certain features of the orthopedicdevice. The term “rigid” is intended to mean an element of the device isgenerally or substantially inflexible. Within the context of frame orsupport members or shells that are “rigid,” it is intended to indicatethat they do not lose their overall shape when force is applied. Theterm “flexible” or “malleable”, by contrast, is intended to encompassfeatures that are capable of bending or flexing under load.

FIG. 1 illustrates a brace 100 configured for attachment to a joint of auser, in accordance with some embodiments. Brace 100 includes at leastone of lateral portion 160 configured to abut a lateral side of anappendage of a user, and a medial portion 170 configured to abut amedial side of the appendage of the user. As will be described in moredetail in connection with the following figures, lateral and medialportions 160, 170 may each comprise an upper support arm 102, a lowersupport arm 104, and a hinge assembly 106 configured to rotatably coupleupper support arm 102 to lower support arm 104. Hinge assembly 106 isfurther configured to limit a range of motion of upper support arm 102with respect to lower support arm 104 in at least one of a firstrotational direction and a second rotational direction. As will bedescribed in more detail below, each of lateral and medial portions 160,170 may further comprise an upper slider 162 configured to slidablycouple to upper support arm 102 and a lower slider 164 configured toslidably couple to lower support arm 104. Brace 100 may be secured to anappendage of a user utilizing one or more straps configured to secureupper and lower support arms 102, 104 and upper and lower sliders 162,164 against a side of a user's appendage. Various features, aspects andelements of brace 100 will now be described in more detail in connectionwith the following figures.

FIG. 2A illustrates hinge assembly 106 of brace 100 of FIG. 1, inaccordance with some embodiments, while FIG. 2B illustrates hingeassembly 106 of FIG. 2A further comprising a window 124 configured toprovide visual indication of a locked state of hinge assembly 106, inaccordance with some embodiments. Discussion of hinge assembly 106 willbe described in connection with FIGS. 2A and 2B together below.

The terms “hinge” or “hinge assembly” as used herein means a mechanicalcoupler that ties two arms of the brace together while allowingrotational motion through different angular orientations of thelongitudinal axes of the two arms. For example, as shown in FIGS. 2A and2B, hinge assembly 106 mechanically couples upper support arm 102 andlower support arm 104 about an axle 108. Upper and lower support arms102, 104 may comprise any suitably rigid material, e.g., metal, plastic,fiberglass composite, etc.

Hinge assembly 106 comprises a hinge cover 110 configured to cover atleast some internal components of hinge assembly 106 as will bedescribed in more detail below. When in use, hinge assembly 106 isgenerally proximate to the anatomical joint being braced, for exampleand not limitation, a knee or an elbow joint. Hinge assembly 106comprises a first range of motion stop 112 configured to limit a rangeof motion of upper support arm 102 with respect to lower support arm 104in a first rotational direction. Hinge assembly 106 may further comprisea second range of motion stop 114 configured to limit a range of motionof upper support arm 102 with respect to lower support arm 104 in asecond rotational direction opposite the first rotational direction. Insome embodiments, first and second range of motion stops 112, 114 maycomprise any suitably resilient material, e.g., plastic, which in somecases may be injection molded.

Hinge assembly 106 comprises an outer housing 116 configured to encloseat least some internal components of hinge assembly 106 as will bedescribed in more detail below. Outer housing 116 comprises one or morefasteners 118 configured to secure outer housing 116 to hinge assembly106. In some embodiments, fasteners 118 may be rivets, screws, or anyother suitable fastening element(s). Outer housing 116 further comprisesan aperture 120 within which a hinge lock 122 is configured to slide.Hinge lock 122 is configured to lock hinge assembly 106 in a desiredorientation about axle 108 when the hinge lock 122 is positioned in afirst orientation (e.g., a locked orientation). The hinge lock 122 isconfigured to allow hinge assembly 106 to move freely about axle 108within the range of motion set by first and second range of motion stops112, 114 when hinge lock 122 is positioned in a second orientation(e.g., an unlocked orientation). In some embodiments, hinge lock 122 maycomprise a slider, a button, or any other suitable element configured toslide, toggle, or shift between the first orientation and the secondorientation within aperture 120. In some embodiments, the firstorientation may be more proximal to axle 108, within aperture 120,compared to the second orientation.

In some embodiments, as shown in FIG. 2B, hinge cover 110 compriseswindow 124 configured to provide visual indication of a locked state ofhinge assembly 106. For example, a portion of hinge lock 122 may bevisible through window 124 when hinge lock 122 is in the firstorientation, thereby indicating hinge assembly 106 is in a locked state.In such embodiments, the same portion of hinge lock 122, visible throughwindow 124 when hinge lock 122 is in the first orientation, is notvisible through window 124 when hinge lock 122 is in the secondorientation, thereby indicating hinge assembly 106 is not in the lockedstate. In some embodiments, at least the portion of hinge lock 122,visible through window 124 when hinge lock 122 is in the firstorientation, has an easily noticeable color, e.g., red or orange, orother pattern, thereby providing an easily noticeable indication to auser when hinge assembly 106 is in a locked state.

FIG. 3A illustrates a plan view of hinge assembly 106 of the brace ofFIG. 1 in an unlocked configuration, in accordance with someembodiments, while FIG. 3B illustrates a perspective view of hingeassembly 106 of FIG. 3A in the unlocked configuration. FIG. 4Aillustrates a plan view of hinge assembly 106 of the brace of FIG. 1 ina locked configuration, in accordance with some embodiments, while FIG.4B illustrates a perspective view of hinge assembly 106 of FIG. 4A inthe locked configuration. FIGS. 3A-4B illustrate hinge assembly 106 withhinge cover 110 and outer housing 116 removed for easy viewing ofcomponents located thereunder.

Hinge assembly 106 comprises an upper hinge plate 126 coupled to uppersupport arm 102 utilizing any suitable coupling element(s), for examplerivets, screws or welds. At least a portion of upper hinge plate 126 hasa substantially circular perimeter centered about axle 108. At least aportion of the substantially circular perimeter comprises a plurality ofteeth 128. In some embodiments, upper hinge plate 126 and upper supportarm 102 may be formed as a single, integral component.

Hinge assembly 106 comprises a lower hinge plate 130 coupled to lowersupport arm 104 utilizing any suitable coupling element(s), for examplerivets, screws or welds. At least a portion of lower hinge plate 130 hasa substantially circular perimeter centered about axle 108. At least aportion of the substantially circular perimeter comprises a plurality ofteeth 132. In some embodiments, lower hinge plate 130 and lower supportarm 104 may be formed as a single, integral component. Upper and lowerhinge plates 126, 130 may comprise any suitably rigid material, e.g.,metal, plastic, fiberglass composite, etc.

In the embodiment of FIGS. 3A and 3B, the hinge lock 122 comprises abody in the form of an open frame with a top panel, a partially openbottom panel, and legs extending therebetween, which may be made of aplastic material. The partially open bottom panel is defined by feet 150extending between pairs of legs. A first protrusion 136 a and a secondprotrusion 136 b are formed by two pins, which may be made of metal. Thepins are press fit through aligned openings provided in the top paneland the bottom panel of the hinge lock frame. The centers of the pinsare exposed between the top panel and the bottom panel of the hinge lockframe so they can engage teeth 132. In some advantageous embodiments,the location of the hinge lock in the housing is such that allows teeth132 to be centrally located on the lower hinge plate 130 so the samestamping tool can be used to form both the left and right lower bars.

When locking mechanism 122 is in the second, unlocked orientation asshown in FIGS. 3A and 3B, first and second protrusions 136 a, 136 b arenot in contact with the plurality of teeth 132 of lower hinge plate 130and upper support arm 102 and lower support arm 104 are free to rotatewith respect to one another about axle 108, within a range of motion setby the positions of first and second range of motion stops 112, 114.

However, when locking mechanism 122 is in the first, locked orientationas shown in FIGS. 4A and 4B, first and second protrusions 136 a, 136 bare configured to physically contact opposite sides of one of theplurality of teeth 132 of lower hinge plate 130, thereby prohibitingrotation of hinge assembly 106 and locking upper support arm 102 withrespect to lower support arm 104 in a desired orientation. Anorientation of the plurality of teeth 132 of lower hinge plate 130 withrespect to hinge lock 122, insert 134 and first and second protrusions136 a, 136 b may be such that the same designs for lower hinge plate130, hinge lock 122, insert 134 and first and second protrusions 136 a,136 b may be utilized on any of a lateral or medial side of a jointlocated on either a left or right side of the user's body. For example,the plurality of teeth 132 may extend radially outward from a pointcoincident with a center of axle 108 and the first and secondorientations of hinge lock 122 may both lie along a straight lineextending away from the same point coincident with a center of axle 108.Accordingly, a single design for components of hinge assembly 106 may beutilized on each of the medial and lateral sides of a brace for either aleft or a right joint, thereby reducing part count, as well as designand manufacturing costs.

First and second range of motion stops 112, 114 may have substantiallysimilar structure and functionality and will, therefore, now bedescribed together in connection with FIGS. 3A-4B. First range of motionstop 112 is disposed between hinge cover 110 and lower hinge plate 130,while second range of motion stop 114 is disposed between lower hingeplate 130 and upper hinge plate 126.

First range of motion stop 112 comprises a first protrusion 144 a and asecond protrusion 144 b configured to physically contact opposite sidesof one of the plurality of teeth 128 of upper hinge plate 126 when firstrange of motion stop 112 is in a locked position, thereby immobilizingfirst range of motion stop 112 at a first desired position along theperimeter of upper hinge plate 130. In some embodiments, hinge cover 110(see FIGS. 2A, 2B) may comprise a plurality of teeth similar to theplurality of teeth 128 of upper hinge plate 126 such that first andsecond protrusions 144 a, 144 b also physically contact opposite sidesof one of the plurality of teeth of hinge cover 110 when first range ofmotion stop 112 is in the locked position. Although FIG. 3A does notshow the side of first range of motion stop 112 that contacts upperhinge plate 126, first and second protrusions 144 a, 144 b extendsufficiently toward upper hinge plate 126 to physically contact theplurality of teeth 128 as described above.

First range of motion stop 112 is configured to be pulled in a radialdirection with respect to axle 108, such that first and secondprotrusions 144 a, 144 b clear the plurality of teeth 128, and thenrotated to the first desired position. First range of motion stop 112comprises a plurality of retention arms 140 configured to contact axle108 such that, when first range of motion stop 112 is pulled in theradial direction, axle 108 deflects the plurality of retention arms 140in an outward direction, thereby providing a restoring force thatreturns first range of motion stop 112 to the locked position whenreleased. In some embodiments, first range of motion stop 112 may alsocomprise a backstop element 142 configured to contact axle 108 whenfirst range of motion stop 112 is pulled sufficiently far in the radialdirection, thereby preventing hyperextension of first range of motionstop 112 or of the plurality of retention arms 140. When in the lockedposition, first range of motion stop 112 limits the range of motion ofupper support arm 102 with respect to lower support arm 104 in a firstrotational direction by coming into contact with a first portion 146 oflower hinge plate 130.

First range of motion stop 112, including the plurality of retentionarms 140 and backstop element 142, may be integrally molded as a singlepart, for example, by injection molding. Integrally molding first rangeof motion stop 112 as a single part eliminates part count and reducesboth manufacturing and assembly costs due to labor and/or non-conformityissues that can occur when assembling separate parts. In addition, firstrange of motion stop 112 may be designed for injection molding such thatits molding doesn't require any side action in the tooling. For example,all sides of first range of motion stop 112 may be substantiallyperpendicular to a plane of first range of motion stop 112, or may slopeto one side or the other of perpendicular (but not both at any givenpoint along the sides), so that side molds are not required to allowclearance of stop 112 from its injection mold. This not only reducestool cost and complexity, it also lowers part cost through fastermanufacture cycle time compared to other designs in which side action inthe tooling is required to remove a part from its injection mold.

Second range of motion stop 114 comprises a first protrusion 148 a and asecond protrusion 148 b configured to physically contact opposite sidesof one of the plurality of teeth 128 of upper hinge plate 126 whensecond range of motion stop 114 is in a locked position, therebyimmobilizing second range of motion stop 114 at a second desiredposition along the perimeter of upper hinge plate 126. Where hinge cover110 (see FIGS. 2A, 2B) comprises a plurality of teeth similar to theplurality of teeth 128 of upper hinge plate 126, first and secondprotrusions 148 a, 148 b also physically contact opposite sides of oneof the plurality of teeth of hinge cover 110 when second range of motionstop 114 is in the locked position. Although FIG. 3A does not show theside of second range of motion stop 114 that contacts upper hinge plate126, first and second protrusions 148 a, 148 b extend sufficientlytoward upper hinge plate 126 to physically contact the plurality ofteeth 128 as described above.

Second range of motion stop 114 is configured to be pulled in a radialdirection with respect to axle 108, such that first and secondprotrusions 148 a, 148 b clear the plurality of teeth 128, and thenrotated to the second desired position. Second range of motion stop 114comprises a plurality of retention arms (not shown but substantially thesame as arms 140) configured to contact axle 108 such that, when secondrange of motion stop 114 is pulled in the radial direction, axle 108deflects the plurality of retention arms in an outward direction,thereby providing a restoring force that returns second range of motionstop 114 to the locked position when released. In some embodiments,second range of motion stop 114 may also comprise a backstop element(not shown but substantially the same as backstop element 142)configured to contact axle 108 when second range of motion stop 114 ispulled sufficiently far in the radial direction, thereby preventinghyperextension of second range of motion stop 114 or of the plurality ofretention arms 140. When in the locked position, second range of motionstop 114 limits the range of motion of upper support arm 102 withrespect to lower support arm 104 in a second rotational directionopposite of the first rotational direction by coming into contact with asecond portion (not shown but similar to portion 146) of lower hingeplate 130.

Second range of motion stop 114, including its plurality of retentionarms and backstop element may also be integrally molded as a singlepart, for example, by injection molding and such that its moldingdoesn't require any side action in the tooling as previously describedfor first range of motion stop 112.

FIG. 5A illustrates a plan view of several additional features of hingeassembly 106 of brace 100 of FIG. 1 in an unlocked configuration andwith outer housing 116 removed, in accordance with some embodiments,while FIG. 5B illustrates a plan view of hinge assembly 106 of FIG. 5Ain a locked configuration and with outer housing 116 shown. FIGS. 5A-6illustrate a different embodiment of the protrusions 136 a and 136 b. Inthis embodiment, the two protrusions are formed part of a single insert134, rather than as two separate pins. In some embodiments, insert 134comprises metal, plastic, or any other suitably rigid and inflexiblematerial. In some other embodiments, insert 134 and first and secondprotrusions 136 a, 136 b may be formed as an integral portion of thehinge lock body itself, rather than being a separate insert.

As shown in FIG. 5A, hinge lock 122 may comprise one or more feet 150having a plurality of recesses 152 configured to receive a protrusion154 of upper hinge plate 126 in at least one of the locked and unlockedpositions. For example, in the unlocked position shown in FIG. 5A,protrusion 154 may be disposed in a first recess of the plurality ofrecesses 152, which may substantially retain hinge lock 122 in theunlocked position. However, in the locked position, hinge lock 122 movesin the direction of axle 108 such that protrusion 154 is disposed in asecond recess of the plurality of recesses 152, which may substantiallyretain hinge lock 122 in the locked position. In some embodiments, hingelock 122 may further include, on an opposite side, another foot having aplurality of recesses configured to receive another protrusion of upperhinge plate 126, similar to that described above, may also be provided.The feet may be flexible plastic, and the open bottom of the frameallows the feet to deform inward when the hinge lock is switched betweenlocked and unlocked positions and the protrusions 154 transition betweenthe recesses on the feet. In addition to retaining the hinge lock in thelocked or unlocked state, use of such interlocking protrusions andrecesses in connection with hinge lock 122 may also provide a tactilefeedback to a user that hinge lock 122 has shifted from the lockedposition to the unlocked position, or vice versa, even without the userhaving a clear view of hinge lock 122. Furthermore, this provides asimple structure, where the protrusions and recesses may be integrallyformed parts of the plate and hinge lock body, rather than requiring anextra part or parts to provide this function.

FIG. 7 illustrates a cutaway view of hinge assembly 106 of brace 100 ofFIG. 1, according to some embodiments. As shown in FIG. 7, upper hingeplate 126 may further comprise at least a first spacing element 158 aand hinge cover 110 may further comprise at least a second spacingelement 158 b. First and second spacing elements 158 a, 158 b maycomprise bosses and/or may be configured to physically contact or nestwithin or against one another and/or against hinge cover 110 and upperhinge plate 126, respectively, when hinge cover 110 is installed onupper hinge plate 126, thereby setting a predetermined distance betweenhinge cover 110 and upper hinge plate 126. Utilizing spacing elements158 a, 158 b allows the setting of proper spacing between hinge cover110 and upper hinge plate 126 and thereby prevents excessive loosenessor tightness of hinge assembly 106, as may otherwise occur with the useof rivets for this purpose and which could otherwise make such a braceless supportive due to such increased nominal looseness of hingeassembly 106.

FIG. 8A illustrates a perspective view of a portion of brace 100 of FIG.1, according to some embodiments, while FIG. 8B illustrates aperspective view of a lower portion of brace 100 in a maximally extendedposition, according to some embodiments. FIG. 8A illustrates lateralportion 160 of brace 100, configured to be secured against a lateralside of a user's appendage and joint, and medial portion 170 of brace100, configured to be secured against a medial side of the user'sappendage and joint. Each of lateral and medial portions 160, 170comprise a respective upper support arm 102, lower support arm 104, andhinge assembly 106 as described in this disclosure.

Each of lateral and medial portions 160, 170 further comprises upperslider 162, configured to slidably couple to upper support arm 102 atany of a plurality of incremental degrees of extension, and lower slider164, configured to slidably couple to lower support arm 104 at any of aplurality of incremental degrees of extension. Each of upper and lowersliders 162, 164 may be formed of any suitably rigid material, forexample, plastic, which may, in some cases, be injection molded.

Upper slider 166 comprises a slider lock 167 and upper support arm 102comprises a plurality of indexing apertures 166 configured to receiveslider lock 167. Likewise, lower slider 164 comprises a slider lock 169and lower support arm 104 comprises a plurality of indexing apertures168 configured to receive slider lock 169. In some embodiments, sliderlocks 167, 169 may be integrally formed and/or molded with respectiveupper and lower sliders 166, 168. In some embodiments, slider locks 167,169 may be shaped to fit and/or snap within any of the respectiveindexing apertures 166, 168, thereby locking upper and lower sliders162, 164 at desired degrees of extension with respect to upper and lowersupport arms 102, 104. Although the general shape of slider locks 167,169 and indexing apertures 166, 168 are illustrated as substantiallycircular, any other suitable shape is also contemplated. Slider locks167, 169 are configured to deflect sufficiently to clear respectiveindexing apertures 166, 168 when sufficient force is applied to sliderlocks 167, 169 such as by pushing downward, thereby allowing sliders162, 164 to translate freely with respect to upper and lower supportarms 102, 104 during adjustment between apertures. One way of doing thisis illustrated in FIG. 8B, where the slider lock 169 is molded onto athree-sided cutout 179 forming a flap in the bottom panel of the lowerslider 164. Pressing down on the slider lock pushes the flap down tofree the lock from the aperture and allowing the support arm to beadjusted in extension. FIGS. 8E and 8F illustrate the lower and uppersliders respectively in a fully compressed position.

In another implementation, rather than being riveted onto the supportarms, the cuffs 171 and 173 that are next to the hinge 106 are slidablyengaged with the support arms so that the distance between each cuff171, 173 and the hinge 106 can also be adjusted. One example design ofwith this capability for the cuff 173 is illustrated in FIGS. 9A to 9C.Referring to FIGS. 9A and 9B, in this implementation, the cuff 173 alsohas a slider lock 192 attached to a three-sided cutout forming a flap(similar to the slider lock 169 illustrated in FIG. 8B). The cuff 173also has a support arm retainer 194 molded with the body of the cuff173. To assemble, the cuff 173 slides over the support arm 104 and upnear the hinge 106. The retainer 194 passes through the slot opening 196at the lower end of the arm 104, and then traps the cuff on the arm 104.It prevents the cuff 173 from rotating down, away from the arm 104. Italso prevents rotation about the axis of the leg because it engages theslot down the center of the adjusting locations on the arm. FIG. 9Cshows the cuff 173 near the hinge 106 with the lower slider 164installed on the arm 104 below the cuff 173.

As shown in FIGS. 9D and 9E, the upper hinge adjacent cuff 171 works thesame way, but the slider lock 198 on the cuff 171 has a coil compressionspring underneath, rather than being attached to a bendable flap. FIG.9F shows the cuff 171 near the hinge 106 with the upper slider 162installed on the arm 102 above the cuff 171.

Each of upper and lower support arms 102, 104 may further compriseindexing numerals disposed adjacent to indexing apertures 166, 168,which may facilitate easy verification that the medial and lateral sidesof brace 100 are set to the same degree of extension. Moreover, becauseindexing apertures 166, 168 provide for discrete, rather thancontinuous, increments of extension, the medial and lateral sides ofbrace 100 may be set to the same degree of extension with greateraccuracy compared to continuous adjustment designs. In addition, theindexing numerals are oriented such that they are displayed right sideup when brace 100 is disposed in the proper orientation on the appendageof the user.

In addition, respective lengths and adjustments of upper and lowersliders 162, 164 and upper and lower support arms 102, 104 are such thata broader range of persons (e.g., taller and/or shorter persons) may beaccommodated by brace 100 compared to other braces. For example, uppersupport arm 102 may comprise a first number of indexing apertures 166(e.g., 3), while lower support arm 104 may comprise a second number ofindexing apertures 168 (e.g., 10).

In some embodiments, each lower slider 164 further comprises a pair oftabs 165 integrally formed and/or molded with lower slider 164 andconfigured to contact lower support arm 104 at least when lower slider164 is at its greatest degree of extension with respect to lower supportarm 104, thereby greatly reducing an amount of looseness between lowersupport arm 104 and lower slider 164 at this greatest degree ofextension. Since tabs 165 are integrally formed and/or molded with lowerslider 164, tabs 165 provide a passive tightening feature that does notrequire additional parts, thereby decreasing cost and complicationassociated with manufacturing and/or assembly of brace 100.

In addition, each of upper and lower sliders 162, 164 may be designedfor injection molding such that their molding doesn't require any sideaction in the tooling. For example, all side edges of upper and lowersliders 162, 164 may be substantially perpendicular to a plane of upperand lower sliders 162, 164, or may slope to one side or the other ofperpendicular (but not both at any given point on the sides), so thatside molds are not required to allow clearance of lower sliders 162, 164from their injection molds. In further example, where a portion of upperand lower sliders 162, 164 contact or extend over a respective portionof one side of upper and lower support arms 102, 104, upper and lowersliders 162, 164 do not contact or extend over that same portion on theopposite side of upper and lower support arms 102, 104. Such adeliberate design not only reduces tool cost and complexity, it alsolowers part cost through faster manufacture cycle time compared to otherdesigns in which side action in the tooling is required to remove a partfrom its injection mold.

Brace 100 may further comprise a removable malleoli attachment 175configured to removably snap into a distal end of lower slider 164.Removable malleoli attachment 175 is configured to abut a distal portionof the user's appendage (e.g., an ankle) when brace 100 is worn, therebypreventing or substantially reducing migration of brace 100. A user mayselectively attach or remove removable malleoli attachment 175 fromeither or both lower sliders 164, thereby enjoying the increasedflexibility compared to braces that either do not include malleoliattachments or that provide permanent malleoli features.

Each of lateral and medial portions 160, 170 of brace 100 may furthercomprise a first cuff 171, a second cuff 172, a third cuff 173 and afourth cuff 174, each configured to receive a respective strap forsecuring brace 100 to the appendage of the user at various locationsabove and below the joint of the user. First and third cuffs 171, 173may be disposed proximal to and respectively above and below hingeassembly 106 and the joint of the user, while second and fourth cuffs172, 174 may be disposed distal to and respectively above and belowhinge assembly 106 and the joint of the user. First cuff 171 may becoupled to upper support arm 102, while second cuff 172 may be coupledto or, alternatively, integrally formed and/or molded with upper slider162. Likewise, third cuff 173 may be coupled to lower support arm 104,while fourth cuff 174 may be coupled to or, alternatively, integrallyformed and/or molded with lower slider 164. First, second, third andfourth cuffs 171-174 may be formed of any suitably rigid material, e.g.,metal, plastic, fiberglass composite, etc.

FIG. 8C illustrates a magnified perspective view of a portion of thirdcuff 173 coupled to lower support arm 104, according to someembodiments, while FIG. 8D illustrates a perspective view of third cuff173 separate and apart from lower support arm 104 for ease of viewing.Third cuff 173 comprises a first fixing element 177 disposed on one sideof third cuff 172 and configured to receive a buckle for securing astrap of brace 100. In some embodiments, first fixing element 177comprises a hook. Third cuff 173 comprises a second fixing element 178disposed on an opposite side of third cuff 172 and configured to receivea strap retaining element, for example a cam and/or flap comprising ahook-and-loop, snap, or any other suitable fastening material on itsunderside configured to attach to and immobilize the strap. In someembodiments, such a cam and/or flap has an increased resistance torotation when raised to prevent it from prematurely contacting the strapand thereby undesirably impeding strap adjustment, and a reducedresistance to rotation when partially lowered to facilitate contactbetween the cam and/or flap and the strap. In some embodiments, secondfixing element 178 comprises a bar or shaft. Third cuff 173 furthercomprises a round boss or protrusion 176 configured to extend through amating aperture in lower support arm 104, thereby aligning third cuff173 for attachment with rivets 195 to lower support arm 104 without aneed for an added fixture for such alignment during manufacture.

First cuff 171 may have substantially similar form and construction tothird cuff 173, however, protrusion 176 being configured to extendthrough a mating aperture in upper support arm 102 rather than lowersupport arm 104. Second and fourth cuffs 172, 174 may have substantiallysimilar form and construction to third cuff 173 with respect to at leastfirst and second fixing elements 177, 178.

FIG. 10 illustrates a perspective view of a buckle 180 for use withbrace 100, according to some embodiments. As will be described in moredetail below, several aspects of buckle 180 provide improved resistanceto unintended strap loosening and allow better conformance to at least aportion of an appendage of the user, thereby preventing or substantiallyreducing brace migration when brace 100 is worn by the user. Buckle 180may be formed of any suitably rigid material, e.g., metal, plastic,fiberglass composite, etc.

Buckle 180 comprises a first portion 181 and a second portion 182separated from one another by a space and coupled to one another attheir outer edges via first and second bridging elements 183 a, 183 b.In some embodiments, an upper surface of first and second portions 181,182 may be substantially planar. In other embodiments, the upper surfaceof one or both of first and second portions 181, 182 may have a slightconvex curvature (when viewed from the outside) in at least onedimension. In this way, a strap may pass over the upper surfaces offirst and second portions 181, 182.

In some embodiments, first and second bridging elements 183 a, 183 b mayhave a substantially elliptical or football-shaped cross-section,perpendicular to the upper surfaces of first and second portions 181,182, such that first and second bridging elements 183 a, 183 b bowoutward toward their middles with respect to their direction ofextension. In this way, first and second bridging elements 183 a, 183 bmay limit lateral strap movement within buckle 180.

Buckle 180 further comprises a shaft 184 extending between first andsecond bridging elements 183 a, 183 b in the space between facing edgesof first and second portions 181, 182. Shaft 184 may be substantiallycylindrical, having a longitudinal axis extending substantially parallelto an upper surface of at least one of first portion 181 and secondportion 182, and substantially perpendicular to facing surfaces of firstand second bridging elements 183 a, 183 b. Shaft 184 may be disposedsuch that its longitudinal axis lies substantially in, or slightlybelow, a plane of the upper surface of at least one of first portion 181and second portion 182. At least a portion of shaft 184 is configured tocontact a strap passing through buckle 180.

First portion 181 may further have a beveled edge 187 facing secondportion 182 configured to direct the strap as it passes through buckle180. First portion 181 may further comprise one or more ridges 188 onits upper surface configured to provide increased resistance to strapmovement when brace 100 is worn.

Second portion 182 comprises an aperture 185 configured to receive ahook of any of first, second, third or fourth cuffs 171-174. Secondportion 182 further comprises a recessed portion 186 having a reducedthickness adjacent to aperture 185. Recessed portion 186 is configuredto abut at least a portion of the hook of any of first, second, third orfourth cuffs 171-174, thereby restraining lateral movement of buckle 180when coupled to any of cuffs 171-174. A segment of second portion 182,having width “W,” separating an inner edge of second portion 182 and anadjacent edge of aperture 185 is designed to be as narrow as practical,thereby reducing a total length of buckle 180. Such a reduced totallength of buckle 180 allows buckle 180 to more closely conform to anarrow portion of the appendage of the user (e.g., the ankle) comparedto buckles having longer total lengths, which further prevents orsubstantially reduces brace migration when brace 100 is worn byfacilitating a closer fit with the appendage. In some embodiments, whileinner, facing edges of first and second portions 181, 182 may besubstantially parallel to each other, opposing, outer edges of first andsecond portions 181, 182 may be substantially curved.

FIG. 11 illustrates a flowchart 1100 of a method of restricting a rangeof motion of a joint of a subject utilizing a brace configured forattachment to the joint, in accordance with some embodiments. Flowchart1100 may apply to the utilization of any brace described in thisdisclosure. While certain blocks are described, flowchart 1100 mayinclude more, fewer or different blocks, steps and/or actions from thosedescribed, and/or in the same or a different order than described.

Block 1102 includes securing an upper support arm of the brace againstan upper portion of an appendage of the subject. For example, aspreviously described, upper support arm 102 may be secured to an upperportion of an appendage (e.g., a thigh) of a user via one or morestraps, in some cases, utilizing first cuff 171.

Block 1104 includes securing a lower support arm of the brace against alower portion of the appendage. For example, as previously described,lower support arm 104 may be secured to a lower portion of an appendage(e.g., a lower leg) of a user via one or more straps, in some cases,utilizing third cuff 173.

Block 1106 includes restricting a range of motion of the upper supportarm with respect to the lower support arm utilizing a hinge assembly ofthe brace. For example, as previously described, hinge assembly 106comprises upper hinge plate 126 coupled to upper support arm 102, lowerhinge plate 130 coupled to lower support arm 104, and axle 108 rotatablycoupling upper hinge plate 126 and lower hinge plate 130. Upper hingeplate 126 comprises a first plurality of teeth 128 disposed along atleast a portion of a perimeter of upper hinge plate 126, while lowerhinge plate 130 comprises a second plurality of teeth 132 disposed alongat least a portion of a perimeter of lower hinge plate 130. Hingeassembly 106 further comprises a locking element 122 disposed on upperhinge plate 126, locking element 122 comprising first protrusion 136 aand second protrusion 136 b configured to physically contact oppositesides of one of second plurality of teeth 132 in a first orientation,thereby prohibiting rotation of upper support arm 102 with respect tolower support arm 104.

FIG. 12 illustrates a flowchart 1200 of a method of manufacturing abrace configured to restrict a range of motion of a joint of a subject,in accordance with some embodiments. Flowchart 1200 may apply to themanufacture of any brace described in this disclosure. While certainblocks are described, flowchart 1200 may include more, fewer ordifferent blocks, steps and/or actions from those described, and/or inthe same or a different order than described.

Block 1202 includes providing an upper support arm. For example,providing upper support arm 102 may comprise receiving and makingavailable, forming, molding or stamping upper support arm 102, which maybe formed of any suitably rigid material, e.g., metal, plastic,fiberglass composite, etc.

Block 1204 includes providing a lower support arm. For example,providing lower support arm 104 may comprise receiving and makingavailable, forming, molding or stamping lower support arm 104, which maybe formed of any suitably rigid material, e.g., metal, plastic,fiberglass composite, etc.

Block 1206 includes assembling a hinge assembly. For example, assemblinghinge assembly 106 may include coupling upper hinge plate 126 to uppersupport arm 102 utilizing any suitable coupling element(s), for examplerivets, screws or welds. Upper hinge plate 126 includes a firstplurality of teeth 128 disposed along at least a portion of a perimeterof upper hinge plate 126. Assembling hinge assembly 106 may furtherinclude coupling lower hinge plate 130 to lower support arm 104utilizing any suitable coupling element(s), for example rivets, screwsor welds. Lower hinge plate 130 includes a second plurality of teeth 132disposed along at least a portion of a perimeter of upper hinge plate130. Assembling hinge assembly 106 may further include rotatablycoupling upper hinge plate 126 and lower hinge plate 130 via axle 108.Assembling hinge assembly 106 may further include disposing lockingelement 122 on upper hinge plate 126. Locking element 122 includes firstprotrusion 136 a and second protrusion 136 b configured to physicallycontact opposite sides of one of the second plurality of teeth 132 in afirst orientation, thereby prohibiting rotation of upper support arm 102with respect to lower support arm 104.

Although the present disclosure has been described in terms of certainpreferred features, other features of the disclosure includingvariations in dimensions, configuration and materials will be apparentto those of skill in the art in view of the disclosure herein. Inaddition, all features detailed in connection with any one aspect hereincan be readily adapted for use in other aspects herein. The use ofdifferent terms or reference numerals for similar features in differentembodiments does not imply differences other than those which may beexpressly set forth. Accordingly, the present disclosure is intended tobe described solely by reference to the appended claims, and not limitedto the preferred embodiments disclosed herein.

1. A brace configured to restrict a range of motion of a joint of asubject, the brace comprising: an upper support arm; a lower supportarm; and a hinge assembly comprising: an upper hinge plate coupled tothe upper support arm and comprising a first plurality of teeth disposedalong at least a portion of a perimeter of the upper hinge plate; alower hinge plate coupled to the lower support arm and comprising asecond plurality of teeth disposed along at least a portion of aperimeter of the lower hinge plate; an axle rotatably coupling the upperhinge plate and the lower hinge plate; and a locking element disposed onthe upper hinge plate, the locking element comprising a first protrusionand a second protrusion configured to physically contact opposite sidesof one of the second plurality of teeth in a first orientation, therebyprohibiting rotation of the upper support arm with respect to the lowersupport arm.
 2. The brace of claim 1, wherein the first protrusion andthe second protrusion of the locking element are integrally formed as asingle piece with the locking element.
 3. The brace of claim 1, whereinthe first protrusion and the second protrusion of the locking elementare integral portions of an insert of the locking element.
 4. The braceof claim 1, wherein the locking element is configured to shift from thefirst orientation to a second orientation in which the first protrusionand the second protrusion do not physically contact the second pluralityof teeth, thereby allowing rotation of the upper support arm withrespect to the lower support arm, the shift from the first orientationto the second orientation traversing a straight line extending from acenter of the axle.
 5. The brace of claim 1, wherein the hinge assemblyfurther comprises at least a first range of motion stop configured tolimit a range of motion of the upper support arm with respect to thelower support arm in a first rotational direction about the axle.
 6. Thebrace of claim 5, wherein the first range of motion stop comprises afirst protrusion and a second protrusion configured to physicallycontact opposite sides of one of the first plurality of teeth of theupper hinge plate when the first range of motion stop is in a lockedposition, thereby immobilizing the first range of motion stop at a firstdesired position along the perimeter of the upper hinge plate.
 7. Thebrace of claim 5, wherein the first range of motion stop comprises aplurality of retention arms configured to hold the first range of motionstop in a locked position.
 8. The brace of claim 7, wherein the firstrange of motion stop, including the plurality of retention arms, is asingle integral part.
 9. The brace of claim 7, wherein the plurality ofretention arms contact the axle such that pulling the at least a firstrange of motion stop in a radial direction with respect to the axlecauses the axle to deflect the plurality of retention arms in an outwarddirection, thereby providing a restoring force that returns the firstrange of motion stop to the locked position.
 10. The brace of claim 1,the hinge assembly comprising: a hinge cover comprising a windowconfigured to display at least a portion of the locking element when thelocking element is configured to prohibit rotation of the upper supportarm, wherein the portion of the locking element has a red or orangecolor.
 11. (canceled)
 12. (canceled)
 13. (canceled)
 14. (canceled) 15.The brace of claim 5, wherein the at least a first range of motion stopcomprises a backstop element configured to prevent hyperextension of thefirst range of motion stop in a radial direction with respect to theaxle.
 16. The brace of claim 10, wherein the upper hinge plate furthercomprises a first spacing element configured to contact the hinge coverand the hinge cover further comprises a second spacing elementconfigured to physically contact the upper hinge plate, therebyproviding a predetermined spacing between the upper hinge plate and thehinge cover.
 17. The brace of claim 1, wherein: the portion of theperimeter of the upper hinge plate is substantially circular about acenter of the axle; and the portion of the perimeter of the lower hingeplate is substantially circular about a center of the axle.
 18. Thebrace of claim 1, further comprising: an upper slider configured toslidably couple to the upper support arm at any of a first plurality ofincremental amounts of extension; and a lower slider configured toslidably couple to the lower support arm at any of a second plurality ofincremental amounts of extension.
 19. The brace of claim 18, wherein:the upper slider and the lower slider each comprise a respective lockingelement; and the upper support arm and the lower support arm eachcomprise a respective plurality of indexing apertures configured toreceive the respective locking element, thereby locking the upper sliderat a first incremental degree of extension with respect to the uppersupport arm and locking the lower slider at a second incremental degreeof extension with respect to the lower support arm.
 20. The brace ofclaim 19, wherein each of the upper support arm and the lower supportarm comprises a plurality of indexing numerals disposed adjacent to theplurality of indexing apertures.
 21. The brace of claim 20, wherein anorientation of the plurality of indexing numerals corresponds to acorrect orientation of the brace for attachment to the joint of thesubject.
 22. The brace of claim 18, wherein the lower slider comprisesat least one tab integrally formed with the lower slider and configuredto contact the lower support arm at least when the lower slider isdisposed at a greatest amount of extension with respect to the lowersupport arm.
 23. The brace of claim 18, further comprising a malleoliattachment configured to removably snap into a distal end of the lowerslider, the malleoli attachment configured to abut a distal portion ofan appendage of the subject when the brace is attached to the joint ofthe subject. 24-39. (canceled)
 40. A method of manufacturing a braceconfigured to restrict a range of motion of a joint of a subject, themethod comprising: providing an upper support arm; providing a lowersupport arm; and assembling a hinge assembly by: coupling an upper hingeplate to the upper support arm, the upper hinge plate comprising a firstplurality of teeth disposed along at least a portion of a perimeter ofthe upper hinge plate, coupling a lower hinge plate to the lower supportarm, the lower hinge plate comprising a second plurality of teethdisposed along at least a portion of a perimeter of the lower hingeplate, rotatably coupling the upper hinge plate and the lower hingeplate via an axle, and disposing a locking element on the upper hingeplate, the locking element comprising a first protrusion and a secondprotrusion configured to physically contact opposite sides of one of thesecond plurality of teeth in a first orientation, thereby prohibitingrotation of the upper support arm with respect to the lower support arm.